Nonalcoholic fatty liver disease in patients with inflammatory bowel disease: Beyond the natural history

Table 1 Comparison of patient characteristics, metabolic profile and laboratory findings among inflammatory bowel disease patients with and without nonalcoholic fatty liver disease

Variables, mean (SD)	NAFLD	No-NAFLD	P value
Age (yr)	53.9 (12.9)	46.9 (13.5)	0.0007
Disease duration (yr)	10.7 (7.6)	11.5 (8.7)	0.51
Time of remission (mo)	33.9 (38.2)	21.1 (30.6)	< 0.05
Antropmetric measurements
Weight (kg)	73.5 (14.5)	64.2 (12.0)	< 0.0001
BMI (kg/m²)	26.5 (4.7)	23.9 (3.7)	< 0.0001
Waist circumference (cm)	93.1 (11.5)	85.5 (10.0)	< 0.0001
Visceral fat (%)	10.5 (5.2)	6.8 (3.3)	< 0.0001
Body fat (%)	29.9 (12.6)	27.9 (10.7)	0.23
Lean body mass (%)	31.4 (6.1)	31.1 (7.4)	0.75
Diet daily intake
Kcal	1970.27 (810.42)	1752.35 (689.48)	0.07
Protein (g/day)	90.31 (33.59)	82.69 (33.75)	0.16
Lipid (g/day)	75.18 (34.01)	61.88 (24.77)	0.005
Carbohydrates (g/day)	241.31 (110.81)	225.18 (101.13)	0.35
Laboratory findings
AST (UI/L)	21.1 (6.1)	21.3 (7.5)	0.84
AST (UI/L)	21.1 (6.1)	21.3 (7.5)	0.84
ALT (UI/L)	22.6 (10.3)	20.0 (10.5)	0.09
GGT (UI/L)	24.6 (11.5)	22.1 (28.0)	0.43
Glycemia (mg/dL)	98.1 (28.0)	89.8 (12.2)	0.03
Serum insulin (μUI/mL)	11.5 (14.1)	7.0 (4.1)	0.007
HOMA index	2.49 (2.42)	1.59 (1.10)	0.005
Cholesterol (mg/dL)	192.7 (41.4)	191.9 (39.7)	0.90
Triglycerides (mg/dL)	105.1 (49.4)	93.6 (49.7)	0.15
LDL (mg/dL)	119.8 (36.5)	113.3 (34.1)	0.28
HDL (mg/dL)	56.9 (17.7)	60.9 (17.6)	0.16
Liver stiffness (kPa)	5.5 (2.7)	4.6 (3.5)	0.09

BMI: Body mass index; HOMA: Homeostatic Model Assessment index; AST: Aspartate aminotransferase; ALT: alanine Aminotransferase; GGT: Glutamyltransferase; LDL: Low density lipoprotein; HDL: High density lipoprotein; NAFLD: Nonalcoholic fatty liver disease.

Table 2 Correlation between disease-related factors and nonalcoholic fatty liver disease on univariate analysis

Variables, n (%)	NAFLD		Univariate analysis
	Yes	No	Odds ratio (95%CI)	P value
Sex (Male)	51 (52)	46 (48)	3.17 (1.67-5.99)	0.0005
Smoke	12 (35)	23 (65)	0.69 (0.32-1.51)	0.36
Disease related factors
Disease activity
MAYO	11 (30)	24 (70)	0.62 (0.26-1.50)	0.20
CDAI	6 (54)	5 (46)	1.70 (0.47-6.09)	0.31
Extraintestinal manifestations	20 (40)	31 (60)	0.97(0.50-1.90)	0.94
Extended disease	47 (41)	66 (59)	1.14 (0.61-2.13)	0.68
Disease duration
> 10 yr	35 (42)	48 (58)	1.00 Rif.
< 10 yr	36 (38)	58 (62)	1.17 (0.64-2.14)	0.35
Steroids	12 (27)	31 (73)	0.49 (0.23-1.03)	0.06
Immunomodulators	11 (43)	15 (53)	1.11 (0.48-2.58)	0.80
Biologic therapy	28 (37)	49 (63)	0.78 (0.42-1.43)	0.41
Surgery	11 (31)	24 (69)	0.63 (0.28-1.38)	0.24
Fecal calprotectin (mg/kg)
> 200	29 (40)	44 (60)	1.00 Rif.
< 200	19 (20)	44 (45)	1.53 (0.75-3.12)	0.24
CRP (mg/L, high levels)	30 (36)	53 (64)	0.72 (0.39-1.33)	0.18

CDAI: Crohn’s disease activity index; CRP: C-reactive protein; NAFLD: Nonalcoholic fatty liver disease.

Table 3 Correlation between metabolic factors or alimentary habits and nonalcoholic fatty liver disease on univariate analysis

Metabolic profile, n (%)	NAFLD		Univariate Analysis	P-value
	Yes	No	Odds ratio (95%CI)
BMI (kg/m²)
Normal	24 (27)	65 (73)	1.00 Rif.	Normal
Overweight	29 (49)	30 (51)	2.62 (1.31-5.23)	0.005
Obese	17 (77)	5 (23)	9.21 (3.06-27.70)	0.0002
Waist circumference (cm)
Normal	26 (33)	54 (67)	1.00 Rif.
Overweight	14 (39)	22 (61)	1.30 (0.57-2.94)	0.34
Obese	22 (56)	17 (44)	2.69 (1.22-5.90)	0.001
Visceral fat (> 8)	43 (55)	35 (45)	3.82 (1.91-7.64)	0.001
Diabetes	7 (58)	5 (42)	2.40 (0.72-7.87)	0.14
MetS	22 (66)	11 (34)	4.13 (1.85-9.24)	0.001

BMI: Body mass index; NAFLD: Nonalcoholic fatty liver disease; MetS: Metabolic syndrome.

Table 4 Risk factors for nonalcoholic fatty liver disease among patients on multivariate analysis

Variables	Multivariate analysis	P-value
	Odds ratio (95%CI)
Advanced age	1.04 (1.01-1.07)	0.006
Sex (male)	4.25 (1.95-9.26)	< 0.00001
Obese (BMI)	1.17 (1.06-1.28)	0.001
High lipidic diet	1.02 (1.01-1.03)	0.004

BMI: Body mass index.